西妥昔单抗联合FOLFOX4/FOLFIRI治疗晚期结肠癌的Meta分析

目的:评价西妥昔单抗联合FOLFOX4/FOLFIRI治疗晚期结肠癌的疗效及安全性。方法:检索PubMed、Cochrane library、Web of Science、EMBASE、中国生物医学文献服务系统（China Biology Medicine，CBM）、中国知网、维普、万方等8个数据库。收集关于西妥昔单抗联合FOLFOX4/FOLFIRI治疗晚期结肠癌的随机对照试验，提取资料并且评价文献质量，采用Rev Man5.3软件进行统计分析，95%可信区间估计。结果:两组有效率相比，差异有统计学意义［OR=2.45，95%CI=(1.78，3.36)，P<0.000 01］。两组疾病控制率相比，差异具有统计学意义［OR=3.36，95%CI=(2.20，5.14)，P<0.000 01］。实验组白细胞减少［OR=1.10，95%CI=(0.60，2.02），P=0.76］、皮疹［OR=11.11，95%CI=(6.71，18.38)，P<0.000 01］、血小板减少［OR=1.14，95%CI=(0.64，2.02)，P=0.66］、恶心呕吐［OR=1.06，95%CI=(0.71，1.58)，P=0.76］、周围神经毒性［OR=0.97，95%CI=(0.62，1.53)，P=0.91］、肝功能异常［OR=0.88，95%CI=(0.53，1.45)，P=0.61］、骨髓抑制［OR=0.77，95%CI=(0.45，1.32)，P=0.34］。发生率与对照组相比，除皮疹发生率远高于对照组，差异有统计学意义外，其余毒副反应差异均无统计学意义。结论:西妥昔单抗联合FOLFOX4/FOLFIRI治疗晚期结肠癌可以提高治疗效果，但不会明显增加毒副反应的发生率。

Meta-analysis of FOLFOX4/FOLFIRI combined with cetuximab for metastatic/advanced colon cancer

Objective:To evaluate the effectiveness and safety of FOLFOX4/FOLFIRI combined with cetuximab for metastatic/advanced colon cancer.Methods:Retrieval from PubMed，Cochrane library，Web of Science，EMBASE，China Biology Medicine（CBM），China National Knowledge Infrastructure，VIP，Wan fang)，randomized controlled trial about FOLFOX4/FOLFIRI combined with cetuximab for metastatic/advanced colon cancer were collected.Meta-analysis was conducted by Rev Man5.3 software after data extraction and quality evaluation.Results:There was statistical significance in therapeutic efficacy of metastatic/advanced colon cancer between 2 groups［OR=2.45，95%CI=（1.78，3.36），P<0.000 01］，disease control rate［OR=3.36，95%CI=（2.20，5.14），P<0.000 01］.The incidence of leukopenia［OR=1.10，95%CI=(0.60，2.02)，P=0.76］，rash［OR=11.11，95%CI=(6.71，18.38)，P<0.000 1］，thrombocytopenia［OR=1.14，95%CI=(0.64，2.02)，P=0.66］，nausea and vomiting［OR=1.06，95%CI=(0.71，1.58)，P=0.76］，peripheral nerve toxicity［OR=0.97，95%CI=(0.62，1.53)，P=0.91］，abnormal liver function［OR=0.88，95%CI=(0.53，1.45)，P=0.61］，myelosuppression［OR=0.77，95%CI=(0.45，1.32)，P=0.34］ in trail group，the incidence of rash was much higher than that in the control group，and the difference was statistically significance，and the differences in the other adverse reactions were not statistically significance.Conclusion:FOLFOX4/ FOLFIRI regimens combined with cetuximab has better therapeutic effect in the treatment of metastatic/advanced colon cancer than chemotherapy alone.which can distinctly relieve the patients' disease，and it does not significantly increase the incidence of toxic side effects.